| NPI | 1790901361 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELCHOR COLLANTES Doctor 562-929-4894 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: CA A37955) |
| Additional Taxonomies | 302R00000X Health Maintenance Organization (Licence: CA A37955) |
| 305R00000X Preferred Provider Organization (Licence: CA A37955) | |
| 305S00000X Point of Service (Licence: CA A37955) | |
| Enumeration Date | 2007-04-18 |
| Last Update Date | 2020-08-22 |